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This study investigated the perceptions and experiences of women with physical and cognitive disabilities related to abuse by formal and informal personal assistance providers. Focus groups and individual interviews were conducted with 72 women to explore how women define personal assistance abuse, the barriers they face in handling abuse, and strategies they recommend to prevent and/or stop abuse. Key themes that emerged included (a) the role of social and personal boundary confusion and power dynamics within the personal assistance services relationship; (b) expanded forms of abuse experienced by women with disabilities; (c) the complexity of using family and friends as providers; (d) personal, social, and systemic barriers that impede women's response to abuse; and (e) the benefits of supports that validate women's experiences and bolster their capacities to prevent and manage abuse. Findings suggested that, with experience, support, and appropriate resources, women with disabilities can effectively manage this challenge.